Major Points

  • Parkinsonism may be associated with a variety of underlying pathologies.
  • Most of the conditions that cause parkinsonism have damage of the striatonigral system as the anatomicopathological substrate.
  • The most common causes of parkinsonism are neurodegenerative diseases, each of which has a defining pattern of neuropathology, often characterized by the abnormal accumulation of protein in the form of a cellular inclusion.
  • For many of these conditions, recent molecular genetic findings have helped to define disease pathogenesis and have clarified the relationship between disease entities.
Fig. 11. Wilson's disease. (A) Gross photograph showing cystic degeneration of putamen. (B) Alzheimer type II astrocytes with swollen pale nuclei (H&E stain). (C) Opalski cell (H&E stain).

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